Bupropion and Fluoxetine in Depressive Subtypes

AbstractAn 8-week open, non-randomized study compared the dopamine-specific antidepressant, bupropion, to the serotonin-specific antidepressant, fluoxetine. Of the 57 patients, 10 met DSM-IIIR criteria for bipolar depression. The other 47 met DSM-IIIR criteria for major depressive disorder. Of these, 23 were subclassified as “atypical” whereas 24 were “typical” based on sleep and appetite patterns. In bipolar patients, depression (as indicated by fall in Beck Depression Inventory [BDI] score) improved significantly in eight of nine patients following administration of bupropion (the mean fall = 16.3 [p < 0.003]). In atypical depression patients, depression as measured by BDI improved significantly after bupropion, but not after fluoxetine. Significant improvement was seen following bupropion in 9 of 14, but only in 2 of 9 following fluoxetine. In typical depression, BDI dropped 6.0 (p = 0.09) after bupropion, and 11.8 (p = 0.002) after fluoxetine. Significant improvement was seen after bupropion in 2 or 1...